Arterial blood pressure circadian rhythm in normotensive decompensated cirrhotic patients before and after single paracentesis
Journal Title: Annales Academiae Medicae Silesiensis - Year 2016, Vol 70, Issue
Abstract
INTRODUCTION: Decompensated liver cirrhosis is associated with hemodynamic changes including arterial blood pressure alterations. The aim of the study was to investigate the circadian rhythm variability of arterial blood pressure in relation to reninemia and aldosteronemia in cirrhotic patients with ascites, before and after paracentesis. MATERIAL AND METHODS: The study was performed in 22 normotensive cirrhotics with ascites and 19 healthy controls. Ambulatory arterial blood pressure monitoring was conducted for 24 hours, cardiac output and systemic vascular resistance were determined and circulating renin and aldosterone concentrations were measured. In cirrhotics, the tests were repeated 24 hours after paracentesis. RESULTS: It was demonstrated that as a consequence of paracentesis, the mesor values of systolic and diastolic blood pressure and heart rate decreased, whereas the amplitudes did not change in the cirrhotics. Moreover, in the cirrhotics' acrophases of blood pressure occurred earlier than in the controls. The day-night differences of mean pressure values were smaller in the cirrhotics than in the controls. The patients before paracentesis demonstrated higher cardiac output and lower systemic vascular resistance than healthy subjects. In cirrhotic patients the renin and aldosterone concentrations were higher and the aldosterone/renin ratio was lower than in the controls. CONCLUSIONS: Arterial blood pressure circadian rhythm in normotensive patients with decompensated cirrhosis of the liver with ascites is characterized by a lowered decrease at nighttime that suggests the occurrence of non-dipping phenomenon. The reduction of ascites in patients with decompensated liver cirrhosis leads to a reduction in arterial blood pressure and does not eliminate the non-dipping phenomenon in its day-night rhythm. In normotensive cirrhotic patients with ascites before and after single paracentesis, a dissociation of the renin-aldosterone nexus occurs.
Authors and Affiliations
Czesław Marcisz, Arkadiusz Orzeł, Adriana Kowalik-Kabat, Halina Kulik, Joanna Balicka, Anna Olejko
Concentration of neutrophil gelatinase-associated lipocalin (NGAL) in serum obtained from different vascular areas during surgical repair of abdominal aortic aneurysm
INTRODUCTION: Neutrophil gelatinase-associated lipocalin (NGAL) is a secretory protein found in neutrophils, endothelial cells and in various organs of the gastrointestinal, respiratory, excretory and reproductive system...
Potencjał e- i m-zdrowia oraz sprofilowanego do potrzeb i oczekiwań płci podejścia w bardziej efektywnej edukacji zdrowotnej i prewencji chorób sercowo-naczyniowych u kobiet
Choroby sercowo-naczyniowe (ChSN) stanowią najczęstszą przyczynę zgonów na świecie. Tylko w roku 2012 z powodu ChSN zmarło 17,5 miliona osób. Mimo że problem ten dotyczy przedstawicieli obu płci, każdego roku więcej kobi...
Systemy automatycznej dystrybucji leków (unit dose) w szpitalach w Polsce oraz w wybranych krajach świata
Implementowanie automatycznych i informatycznych technologii w medycynie i farmacji może zredukować liczbę błędów medycznych. Nowoczesnymi technologiami, pozwalającym ich uniknąć, są system automatycznego dozowania leków...
Histamina w serach – potencjalne zagrożenie?
Sery należą do produktów o wysokiej zawartości tłuszczu, białka i innych związków nieorganicznych. Są wyrobem spożywczym, który może różnić się jednostkowo w zależności od swojego pochodzenia, warunków wytwarzania, flory...
Regional Committees for the Adjudication of Medical Cases – assessment of 16-months of operation
INTRODUCTION On the basis of the amendment of the Act of 6 November 2008 on Patients' Rights and Patients' Rights Ombudsman (PRO), provincial committees for the adjudication of medical cases were appointed. The aim of th...